title: Fifteen years after a ferry disaster: clinical interviews and survivors' self-assessment of their experience.
abstract: BACKGROUND
  Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past.
  
  
  OBJECTIVE
  We aimed to examine diagnostic status and survivors' views on disaster-related consequences and social support.
  
  
  METHODS
  A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders.
  
  
  RESULTS
  The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the long-term consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants' sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others.
  
  
  CONCLUSIONS
  Axis-I disorders were prevalent, but not salient to survivors' perceptions in the long-term. Post-disaster interventions need to attend to common barriers to support.
authors.affiliation: Department of Neuroscience, National Centre for Disaster Psychiatry, Uppsala University, Uppsala, Sweden.
authors.forename: Filip K
authors.initials: FK
authors.lastname: Arnberg
authors.forename: Christina M
authors.initials: CM
authors.lastname: Hultman
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Michel
authors.forename: Tom
authors.initials: T
authors.lastname: Lundin
keywords: Survivors; diagnosis; mixed methods; posttraumatic growth; posttraumatic stress disorder; social support